Chronic traumatic encephalopathy in athletes, players, boxers and military: systematic review

Abstract

The objective of the study was to demonstrate whether athletes, players, boxers and military personnel can really be victims of CTE, and to elucidate this pathology. In 53 articles, 14 were selected for qualitative synthesis in the results table that addresses CTE in football, soccer and rugby players, boxers and the military. Neuropathologically, CTE shows cerebral atrophy, a pelvic septum cavity with fenestrations, dense diffuse immunoreactive inclusions and a TDP-43 proteinopathy. Microscopically, there are extensive neurofibrillary tangles and spindle-shaped neurites throughout the brain. Thus, CTE is characterized by being a distinct tauopathy and with a clear environmental etiology. American football players, boxers and the military are more likely to trigger CET, due to the constant mechanical shocks from their heads. The most frequent clinical manifestations were: headache, aggressiveness, dementia, executive dysfunction and suicide. CET is definitely diagnosed only at autopsy, there is no specific treatment for it, but support and safety measures can help the patient. Advances to definitively diagnose CTE in living people and specific treatment for this disease are needed.